ONTARIO AUTO INSURANCE
FREQUENTLY ASKED QUESTIONS
Updated: October, 2006
Introduction
Applying for auto insurance
- What do I need to know to fill out an insurance application?
- What is the impact of inaccuracies or omissions in applications
for automobile insurance?
- Why is it important to pay premiums on time?
- What should I know about lapses in insurance coverage?
- What coverage is a must-have and what coverage is optional?
- How do deductibles work?
1
2
3
3
4
4
7
Establishing premiums
- What influences my premium?
- How can I get a premium discount?
- How do claims affect my premium?
- How do convictions affect my premium?
8
8
8
9
If you have to make a claim
- What do I do if I’m in an accident?
- What should I know about filing a claim?
- Determining Fault. No-fault insurance: What’s it all about?
- How do Accident Benefits coverages work?
- What happens when a vehicle is a “total loss”?
- Why isn’t my car always repaired with new parts?
11
12
13
16
17
18
After the claim
- Branding program: What happens if my vehicle is severely damaged?
19
Driving in the United States
21
With appropriate acknowledgement, this publication may be reproduced and used in whole or in
part, provided such reproduction is intended for personal or educational use and not for
monetary gain of any kind. In all written or spoken references to this information, please include,
"Information provided courtesy of Insurance Bureau of Canada."
Ontario Auto Insurance: FAQs
1
INTRODUCTION
Every year, information officers at Insurance Bureau of Canada's Consumer Information Centres
answer tens of thousands of questions from insurance policyholders across the country. At the
Ontario Consumer Information Centre, many of these questions are about automobile insurance.
Automobile insurance is complex. As a consumer, you should examine your policy carefully to
understand every detail. Yet few people bother to read their policies until they are involved in an
accident, a car they own is broken into or they have some other problem.
When shopping for auto insurance, remember that the wording of your policy will be the same no
matter which insurance company issues it, because the Ontario automobile policy and related
endorsements (endorsements are add-ons to basic coverage) are forms approved by Financial
Services Commission. However, not all companies provide the add-ons. Your insurance
representative can help you decide what coverage is best for you.
In this publication, we've done our best to answer the questions most often asked about car
insurance in Ontario. If you have other questions or need more information, please call us (see
our contact information below). The Consumer Information Centre can also help you with your
home and business insurance.
CONSUMER INFORMATION CENTRE
Monday through Friday between 8:00 a.m. and 5:00 p.m.
In Toronto: 416- 362-9528
Elsewhere in Ontario: 1-800-387-2880
Fax: 416-644-4961
Website: http:// www.ibc.ca
Ontario Auto Insurance: FAQs
2
APPLYING FOR AUTO INSURANCE
What do I need to know to fill out an automobile insurance application?
Here is some of the information you’ll need to provide on an automobile insurance application:
1. Vehicle information
 Year, make, model, body type, cylinder or c.c.
 Vehicle identification number (serial number)
 Estimated annual driving distance
 Lien holder name and postal address (the person or group you are still making payments
to if your car loan is not paid in full)
 Automobile use – pleasure, business, driving to work
2. Driver information
 Name of each driver, driver's licence number, date of birth, date first licensed in Canada,
other classes of licence (if any), the percentage each driver uses the vehicle(s).
 Whether any insured drivers have driver training. If so, his or her certificate needs to be
attached so he or she can be considered for a premium discount.
 Whether anyone else in the household or business is licensed to drive. If so, details need
to be provided in the remarks section.
 Whether any driver's licence, vehicle permit, etc., issued to a person in the household or
business has been suspended or cancelled in the last six years.
 Whether any insurance company cancelled automobile insurance for the applicant or any
driver listed on the application in the last three years.
 Whether, during the last three years, any automobile insurance policy issued to you or
any listed driver has been cancelled or any claim has been turned down for material
misrepresentation (not telling the truth).
 Whether the applicant or any listed driver has been found by a court to have committed a
fraud involving automobile insurance.
3. Previous accident and insurance claims in the last six years
 You must show details of any accident or claim on any automobile of any listed driver
during the last six years ("any claim" means all claims and includes windshield damage,
theft, vandalism, wind damage, etc.).
 You need to provide details of the date of claim, type of claim, amount paid or estimate
of damage. If the claim was a collision, you also need to identify the driver and give brief
details on what happened and who was at fault. If you need help, contact your insurance
representative before completing the application.
 You need to identify the offence and the date of conviction(s) for each driver.
Convictions are offences related to the operation of a vehicle. This includes seatbelt
infractions, defective tires or brakes, failure to use or improper use of headlights,
moving traffic offences, such as speeding, and signalling offences.
 You can get your own motor vehicle record (MVR) from the Ministry of
Transportation, which provides a two-year history. Insurance companies require a
three-year history.
 If you don’t know or are unsure of conviction dates, ask your insurance representative.
Ontario Auto Insurance: FAQs
3
What is the impact of inaccuracies or omissions in applications for
automobile insurance?
The information you give on an application for automobile insurance is the basis for:
 the insurance company's decision to issue or decline to issue a policy;
 calculating the premium required and terms and conditions of the policy, if one is issued.
The Insurance Act of Ontario specifies the wording of automobile insurance applications. The
application contains a declaration where you confirm the answers to questions about you and all
the other drivers of the insured automobile in the household or business are correct. There is also
a warning of the possible consequences of leaving things out or not telling the truth – in other
words, errors or omissions in your answers.
When you sign an application, you’re confirming the accuracy and completeness of the
information on that application. Even if your answers are written on the form by someone else,
the responsibility for the answers is yours. Discussions between you and the person completing
the form are not part of your application unless the written answers include that information.
While the insurance company may be able to check the accuracy, you must give complete,
accurate answers. Inaccuracies or omissions may mislead the insurance company. As a result,
your insurance could be invalid (you lose your right to recover a loss) or your policy may be
cancelled. In some cases, your insurance may be considered never to have been in force.
In addition to the difficulties, a cancellation of your policy because of misrepresentation generally
results in you paying more for any policy you are able to get later.
If you’re unsure of your driving and conviction history record or the history for members of your
household, ask your insurance representative what is shown on your existing policy.
You can get motor vehicle records (MVR) for you and members of your household from the
Ministry of Transportation, which provides a two-year history. However, insurance companies
require a three-year history.
Why is it important to pay premiums on time?
It’s important to pay your premium to your insurance company or insurance representative on
time and in the way you have agreed, because there is no "grace period."
Your premium is due as soon as billed by your insurance representative and you should send it
promptly. If you are having problems paying on time, you MUST discuss the situation with
your insurance representative before your account becomes "delinquent." Often, additional
payment time can be arranged or an alternative payment method may be offered. Do not let the
situation slide, or you may find yourself driving without insurance – a serious crime.
If your insurance representative or insurance company is not paid and is unable to get a response
or to reach you, they have no choice but to cancel your policy by hand delivery or registered mail.
Ontario Auto Insurance: FAQs
4
If you do not want to renew a policy, notify your insurance representative promptly. Some people
believe if they have arranged insurance elsewhere they don't need to notify the previous insurance
representative. NOT SO! Your policy will be cancelled for non-payment of premium. This
cancellation will be a "black mark" against your insurance record and your future premiums may
be higher as a result.
If you pay your premium with a series of post-dated cheques or by pre-authorized bank
withdrawals, make sure the money is in your account, ready for transfer to the insurance
company. If you don’t have enough money in the account and the insurance company cancels
your policy, you can't assume your coverage will automatically be reinstated later on.
What should I know about a lapse in insurance coverage?
A lapse in insurance coverage will not be held against you unless:
 your policy was cancelled for non-payment of premium;
 your driver's licence was suspended because of a conviction related to the use or
operation of the automobile, e.g., impaired driving; and/or
 an accident or conviction happened that would result in higher premiums and you wished
to avoid paying more.
When you want insurance coverage at a later date, you need to prove you had prior insurance.
Advise your insurance representative if you are going to cancel your policy or have a lapse in
insurance because:
 you’ve sold your car and do not plan to replace it for a while;
 you are moving out of the country temporarily; or
 you are going to drive a company car and don't need your own vehicle.
Get a letter from your insurance representative outlining your policy number, insurance company,
how long you were insured and your accident and conviction history. Keep this in a safe place.
Or, you can write down the reason for lapse in insurance and make two copies. Give one to the
insurance representative and have him or her sign the other copy for your records. This provides
you with documentation when you need insurance again, in case that broker/agent is no longer
available to verify your lapse in coverage. Also keep a copy of your latest policy.
What coverage is mandatory and what coverage is optional?
Automobile insurance in Ontario is required by law. You must not drive without it.
While the law calls for standard policy wordings and oversees the range of options, there are
many insurers competing on price and service in the Ontario market. Brokers and agents can tell
you which insurers they represent and which companies they get quotes from, and show you
those prices on request.
Retirees: Insurers must offer a premium discount on accident benefits coverage to retirees aged
65 or older, and also to younger retirees if they are receiving a Canada or Quebec Pension or a
Ontario Auto Insurance: FAQs
5
pension registered under the Income Tax Act. For complete details, talk to your insurance
representative. You will be required to sign a Declaration for Retiree Discount.
MUST-HAVE coverage
To drive on public roads in the province, you must have Direct Compensation - Property Damage
coverage, Uninsured Automobile coverage, Third-Party Liability and Statutory Accident
Benefits. These are all compulsory. This means that by law, you must purchase these coverages:
Type of
Coverage
Liability
Accident
Benefits
Uninsured
Motorists
Direct
Compensation
- Property
Damage
What the coverage does
Protects you if someone else is killed or injured or
their property is damaged because of your negligence.
It will pay for legitimate claims against you up to the
limit of your coverage, and will pay for the costs of
settling the claims, including defense costs.
Provides benefits if you are injured or killed in an
automobile accident anywhere in Canada and the
United States regardless of who caused the accident.
Protects you if you are injured or killed by an
uninsured motorist or hit-and-run driver to the extent
you were not at fault.
Covers damage to your automobile caused by an
identified uninsured motorist.
Allows you to claim from your insurance company
for damage to your vehicle and its contents caused by
someone else. Direct compensation-property damage
means that, to the extent that you are not at fault in an
accident with another vehicle, your own insurer will
pay for damage to your vehicle and its contents.
Minimum or limit
requirements
$200,000 (higher limits
are recommended)
The details of the
Accident Benefits
Coverage are set out in
the Statutory Accident
Benefits Schedule of the
Insurance Act of Ontario,
and also available on
Insurance Bureau of
Canada’s website
www.ibc.ca
$200,000 limit
Up to $25,000, subject to
a deductible of $300
Standard $0 deductible
(can be increased)
OPTIONAL coverage:
You are not required by law to purchase Collision coverage or Comprehensive coverage.
However, if you owe money on your vehicle, your lien holder (the person or group you are
making payments to if your car loan is not paid in full) may require you to have these coverages
to protect their interest in your vehicle.
Ontario Auto Insurance: FAQs
6
Type of
Coverage
Collision
Comprehensive
All Perils
Specified Perils
What the coverage does
Minimum or limit
requirements
This coverage pays for damage to your vehicle
to the extent that you are at-fault or for damage
caused by an unidentified vehicle or object
This coverage pays for all insured damage to
your vehicle except for collision damage (e.g.
fire, theft, vandalism)
This coverage combines collision and
comprehensive coverages. It is the broadest
coverage available as it includes all types of
coverage unless specifically excluded.
This coverage pays only for loses caused by
perils specifically listed in the policy,
(primarily fire and theft).
The standard deductible is $500,
however you may choose a
higher deductible in order to
decrease your rates.
Endorsements
In addition to the coverages listed above, you may purchase a number of additions to your
insurance policy (known as “endorsements”). There are three endorsements commonly found
on the typical Ontario automobile policy. They are:
Loss of Use (OPCF 20) - This coverage pays for a rental vehicle if your vehicle requires
repairs after an at-fault accident. Generally, there will be a $1,000 limit to this coverage;
however this amount varies from company to company, so please ask your agent or
broker for the limit applicable to your policy.
Waiver of Depreciation (OPCF 43R) - This endorsement is available to those who
purchase a new vehicle and is available for a period of not more than two (2) years. It
will compensate you for insured losses as if the car were brand new.
Excluded Driver Endorsement (OPCF 28A) - This endorsement does not provide you
with any coverage, in fact it removes coverage if the excluded driver listed on the form
drives your vehicle. It is commonly used to remove coverage for a driver with a poor
driving record or claims frequency. It is useful for avoiding an additional premium such
drivers would normally be charged for having access to your vehicle. Please ask your
broker or agent if this would be beneficial to your particular situation.
At Fault “Forgiveness” Endorsement - Many companies now offer an endorsement for an
additional premium that will “forgive” your first at fault accident with them. The name,
cost, and conditions of this endorsement vary from company to company, so please ask
your broker or agent for details regarding the options available through your insurance
company.
Ontario Auto Insurance: FAQs
7
There are many other endorsements available that are less common but may be of benefit
to you. Your insurance representative will be familiar with all of them, and will advise
you if any would be of benefit to you.
How do deductibles work?
A deductible is the part of a claim that you must pay yourself. Higher deductibles usually mean
lower premiums but higher financial risk.
Under the Direct Compensation - Property Damage provisions of your policy, if you’re not at
fault in an accident (in Ontario involving another Ontario-insured vehicle), there is no deductible
unless you have chosen to lower your premium by selecting one. However, if you have selected a
deductible, the full amount of it will apply, regardless of your degree of fault for the accident.
If you have bought optional coverage for collision or upset, or all perils, and if you are fully
at fault for the damage to your vehicle, a standard $300 deductible applies (unless you have
selected another amount). However, if you have no direct compensation deductible, and you
are only partially at fault, your deductible will be reduced accordingly. If you are partially at
fault, and if you have both a direct compensation deductible and a deductible for collision or
upset (or all perils), your insurance representative will explain how these will apply.
If you are claiming for losses unrelated to a collision (hail dents, for example) your full
deductible applies.
Ontario Auto Insurance: FAQs
8
ESTABLISHING PREMIUMS
What influences my premiums?
Automobile premium levels are affected by many factors, such as:
 ways you use your vehicle (Do you use your vehicle just for pleasure? Do you drive to
work or do you use your car for business?);
 the type of vehicle you drive;
 the year, make, model and body type of your vehicle;
 the approximate number of kilometres you drive your vehicle annually;
 who will be driving the vehicle;
 the age and driving experience of each driver in the household (Are drivers under age 25
male or female?);
 how much each driver will be using the vehicle;
 the claims and accident history for each driver over the last six years;
 each driver's conviction record for the last three years; and
 whether any driver in the household has had a licence suspension or an automobile policy
cancelled in the last six years.
How can I get a premium discount?
Discounts vary by company. Ask your insurance representative which ones apply to you. The
following is a list of some types of premium discounts that may be available.







Some companies offer discounts for using your car very little (low-mileage use), for
graduating from an approved driver training courses, or volume discounts when two or
more vehicles are insured for the same household.
Retirees with no employment income receive a discount. Some companies provide other
discounts to mature drivers over age 55.
You may be eligible for a discount if you choose to insure your home and car with the
same company.
You may get a discount if you install loss-prevention devices such as car immobilizer.
If your car is not used in winter, speak to your insurance representative about arranging a
suspension-of-coverage endorsement. This stops the Third-Party Liability and Collision
coverage. Accident Benefits coverage (when you're a passenger in someone else's car or a
pedestrian) and coverage for fire, theft, vandalism damage, etc. would still be provided
while you store your vehicle.
Increasing your deductibles could give you a lower premium.
Some companies provide an extra discount when renewing policies for long-time
customers who are claims-free.
How do claims affect my premium?

If you are at fault or partially at fault in a collision, your renewal premium may be
affected.
Ontario Auto Insurance: FAQs
9


If you lend your car to others and they cause an accident, your premium may be affected.
A lot of "at-fault" claims and/or driving convictions could result in your being transferred
to the high-premium Facility Association at renewal time.
Some types of claims do not affect you premium. For example, many companies allow one
"at-fault" claim for clients believed to be good drivers and make little or no adjustment in
rating or premium at renewal. Claims for theft, vandalism, fire, broken glass and for collision
when you are not at fault do not affect your renewal premium.
How do convictions affect my premium?
Driving convictions, including seatbelt infractions, may affect your rating in several ways
depending on the number and type. Premium calculations vary by company. Contact your
insurance representative if you’re concerned about how a conviction will affect your renewal
premium.
To be eligible for preferred rating plans, such as "six star," you must have a clear record or no
more than one or two minor driving convictions (requirements vary by insurance company).
Additional convictions usually result in the loss of your preferred status and discounted
premiums. So, in addition to the fine you pay, your insurance costs can go up.
Insurance companies may also levy a premium surcharge if you have several minor driving
offences or one of the more serious offences under the Criminal Code of Canada or the Highway
Traffic Act. Surcharges vary by company but many use the Facility Association rules as a
guideline.
The following is an example of premium surcharges the Facility Association applies on private
passenger vehicles:
Minor
Major
Serious
One conviction 15%
One conviction 100%
One conviction 0%
Two convictions 5%
Each additional conviction 25% Each additional conviction 100%
Three convictions 15%
Four convictions 25%
Each additional 15%
Note: The maximum surcharge the Facility Association applies is 250%.
What constitutes a minor, major and serious offence?
Minor
Convictions for any moving traffic offence
(offences related to the operation of a vehicle),
other than those listed as Serious or Major, under
an act governing highway traffic or Compulsory
Ontario Auto Insurance: FAQs
Major
Convictions for the following offences
under any act governing highway traffic of
Compulsory Automobile Insurance Act
(CAIA) or offences substantially the same
Serious
Convictions for the following
offences under the Criminal
Code of Canada or under an act
governing highway traffic or any
other act or any offences
10
Automobile Insurance Act (CAIA) or for any
offence substantially the same committed within or
outside Canada including:







































failure or refusal to surrender licence (CAIA )
failure to produce evidence of insurance
(CAIA)
failure to carry insurance card (CAIA)
failure to carry evidence of insurance (CAIA)
failure to have insurance card (CAIA )
failure to disclose particulars (CAIA )
failure to notify police
failure to make written report
failure to report damage to highway property
backing up – unsafe/illegal/improper – any
type
brakes – none/inadequate/improper – any type
crowding driver’s seat
door opening – illegal/obstructing traffic – any
type
emergency vehicle – operating with no regard
for safety
driving imprudently
driving off roadway (including
shoulder/sidewalk/median) – any type
flagman – disobeying
following too closely (including tailgating)
headlights/parking lights – improper lack of
use – any type
lack of control of vehicle – any type
motor-assisted bicycle – carrying passengers
motorcycle – operating with only an
instruction permit
motorcycle – failure to wear helmet
passing infraction – any type
except school bus or school/playground zone
pedestrian crossing violation – any type
radar warning device in motor vehicle – if
illegal in province/territory
railway crossing – any type
safety zone violation – any type
seatbelt – any offence
signalling offences – any type
slow driving – endangering others – any type
smokescreen device on vehicle
speeding – any type, except when listed as
major or serious
squealing tires
stopping – illegal/improper – any type
stunting
tires – defective/worn – any type
towing – prohibited/unsafe – any type
Ontario Auto Insurance: FAQs
committed outside Canada:

























failure to report an accident
failure, in the event of an accident, to
give name and licence number to the
police or any other person entitled to
such information
failure to obey school crossing stop
sign
improper passing of a school bus
improper passing/speeding in a school
or playground zone
driving without insurance
operating motor vehicle - no insurance
(CAIA )
vehicle owner without insurance
(CAIA)
no insurance (CAIA)
producing false evidence (CAIA)
making a false statement re insurance
(MVACA)
producing false insurance (MVACA)
making a false statement (CAIA)
speeding in excess of 50 km/h over
limit
Ontario Graduated Licence – permit
novice driving in contravention of
conditions/restrictions
class G1, accompanying driver fails or
refuses to provide a breath or blood test
class G1, accompanying driver has
excess blood alcohol
class G1, driver unaccompanied by
qualified driver
class G1, accompanied driver excess
blood alcohol
class G1, driver with front seat
passengers
class G1/G2, driver with excess
passenger
class G1, driver on prohibited highway
class G1/M1, driver driving at unlawful
hour
class M1, driver driving motorcycle
with passenger
class M1, driver driving motorcycle on
prohibited highway
substantially the same whether
committed within or outside
Canada or any convictions
which appear on a Driver Record
Abstract identified as Criminal
Code convictions.














criminal negligence
committed in the operation
or use of a motor vehicle
manslaughter committed in
the operation or use of a
motor vehicle
driving while licence under
suspension
racing
careless driving
driving without due care and
attention
dangerous driving
impaired driving
failure or refusal to submit
to a breath or blood test
failure to pass a breath or
blood test
failure to stop/remain at the
scene of an accident
failure to stop for a police
officer, resulting in a
suspension of licence for a
period in excess of two
weeks
class GI/G2/M1/M2
failure/refuses to give breath
sample
class G1/G2/M1/M2 driver
with alcohol in blood
- one conviction 100%
- each additional conviction
100%
Note: If convictions for impaired
driving and failure or refusal to
take a breath or blood test relate
to the same occurrence, they will
be considered as one conviction.
11
IF YOU HAVE TO MAKE A CLAIM …
What do I do if I’m in an automobile accident?
At the scene
 Keep calm.
 Offer help to anyone injured.
 If the accident is an emergency, call 911 and follow instructions. USE 911 FOR
EMERGENCIES ONLY!
 If the accident is not an emergency, call local police for instructions. In Ontario, all accidents
where someone is injured or there is property damage of $1000 or more must be reported to
the police. However, a number of locations have special programs in place to deal with auto
accidents. Toronto, for example, has Collision Reporting Centres and accidents must be
reported in person to these centres within 24 hours, if police did not attend the accident scene.
Find out what is required where you live, and keep this information in your glove box.
 Move vehicles out of traffic, if possible. Do not drive the vehicle unless it is safe to do so.
 Record details of the accident – how, when, where it happened, time, date, location, speed,
weather and road conditions.
 Draw a sketch of the accident scene showing the position and direction of the vehicles and
the cross streets.
 Keep a camera in your vehicle and take photos of the damage to your vehicle and the damage
to the other vehicle(s). This can be helpful if someone is trying to claim other damage or
there is a dispute as to what happened.
 Answer police questions honestly but make no comments or admit any blame for the accident
to the other driver(s). Your insurance company will determine fault based on the Fault
Determination Rules regulated by the Ontario government.
 Get names, addresses, telephone, driver’s licence and plate numbers, and insurance details
from everyone involved.
 Note the badge numbers of the investigating officers, if police attended the scene.
 Get names, addresses and telephone numbers from witnesses, when possible. It is also helpful
to jot down licence plate numbers of other vehicles if you think someone in them might have
seen the accident, but with moving traffic this may not be possible.
 Be careful of tow truck operators pressuring you to authorize repairs at the scene. You have
the right to request estimates of fees in advance. If you feel you’re being pressured, ask police
for the name of an authorized tow truck operator and have your vehicle towed to the police
compound or your driveway until you talk to your insurance company.
After the accident:
 If police were not at the scene, you must report all accidents resulting in property damage of
$1,000 or more to them. If there isn't a Collision Reporting Centre nearby, call the local
police station for guidance. Often they will ask you to go to the nearest police station to
report.
 Even if you attended a Collision Reporting Centre, report the accident to your insurance
representative as soon as possible. They will explain the coverage provided by your
automobile policy and start handling your claim.
 If you’re injured in the accident, your company will provide you with a package of accident
benefits claims forms, which must be completed to start your benefits.
Ontario Auto Insurance: FAQs
12


Many insurance companies have a list of preferred body shops that will complete proper
repairs to your vehicle. Your insurance adjuster or broker/agent can assist you with finding a
good one in your area.
Your Ontario automobile policy entitles you to have repairs done with parts of similar kind
and quality. In other words, your car should be repaired so it is in a condition approximately
the same as it was prior to the accident. If you don’t feel your vehicle was repaired properly,
report your concerns to your insurance adjuster immediately.
Reporting a collision to the police
The Highway Traffic Act requires any person involved in a car accident to:
 report the collision to the nearest police officer;
 remain at the scene for the purposes of offering assistance when needed; and
 provide insurance information, driver's licence number, name, address, the plate number
and the name and address of the vehicle’s registered owner to a police officer and to any
person involved in the collision.
By law, all collisions must be reported to the police if there are any personal injuries or deaths,
and where the damage to all vehicles is more than $1,000.
Your automobile policy requires you to report such accidents to the insurance company within
seven days. If you are incapacitated by the accident and are unable to report within the seven
days, report it as soon as possible.
The penalty for failing to report a collision and/or failing to provide the necessary information is a
fine of $200 to $1,000, three demerit points, a possible jail term and driver's licence suspension.
The penalty for leaving the scene of a collision includes seven demerit points.
The police are required by law to investigate all reportable motor vehicle collisions and to
provide a report to the Registrar of Motor Vehicles (MTO).
What should I know about filing an insurance claim?
What are the accident benefits to which I’m entitled?
If you're injured in an automobile accident, you may be entitled to a variety of benefits. A full
description of coverage provided is contained in the "Statutory Accident Benefits Schedule." A
copy of this document is available on request from your insurer. Your insurer will provide you
with the necessary claim forms and will help you complete them.
Getting your damaged vehicle repaired
If your vehicle is damaged but repairable (and you have the necessary coverage in your policy)
your insurer may suggest the repairs be carried out by one of their "preferred shops." If this is
done, it will be the responsibility of the insurer to make sure the work is done satisfactorily. You
may, if you wish, have the work done by a repair shop of your choice. However, be aware that the
insurer will not pay any more than the price quoted by their repairer. Also, if the work is
unsatisfactory, it will be your responsibility to deal with the repair shop.
If the damage is major and cannot be repaired safely, or the cost of repairs is more than the value of
the vehicle, the insurer may decide to "write off" the vehicle. They will negotiate a settlement based
on the actual cash value of the vehicle at the time of the accident.
Ontario Auto Insurance: FAQs
13
“Betterment”
When an insurer is paying for a vehicle to be repaired, the shop will replace damaged parts with
parts of the same vintage as the car. For example, the damaged bumper of a 1994 car would be
replaced with a 1994 bumper. If new parts are used, even though used parts are available, the
value of the car may be increased. In such a case an amount will be calculated, known as
"betterment," representing the increase in value, and you may be asked to contribute to the cost of
repairs.
What is covered if my vehicle is broken into?
Criminals find it profitable to steal and sell automobile equipment and accessories. This type of
loss would be covered under your automobile policy if you have bought All Perils,
Comprehensive or Specified Perils coverage.
However, your personal property in the vehicle, such as audiotapes (except for one in the
machine), briefcases, suitcases, golf clubs, skis, bikes, fishing equipment and so on, is not
covered under the automobile policy. For these things you need Homeowner’s, Tenant’s or
Condominium insurance. Personal property is usually insured for up to 10% of the amount of the
policy limit or $1,500, (whichever is greater) while this property is temporarily away from your
premises, anywhere in the world.
You may have to pay two deductibles. There is a deductible for the automobile policy (except in the
case of fire, lightning). Your Homeowner’s/Tenant’s/Condominium policy has a separate deductible.
If you leave the keys in the car or leave it unlocked, the vehicle itself (and its accessories) will be
covered under your automobile policy if you have purchased coverage. As for the contents, some
Homeowner’s, Tenant’s and Condominium policies require visible signs of forced entry into a
locked vehicle as a policy condition. Claims from an unlocked vehicle would not be covered by
these policies.
Locking bikes or skis in your vehicle
The trunk of a full-size car can accommodate a bicycle if you take the front wheel off. Some cars
have a special hatch or sleeve to accommodate skis and poles so they extend from the trunk into
the rear seat area. Ask your insurance representative about scheduling your sports equipment,
cameras and other vulnerable items with additional coverage, especially if your policy has a
forced entry policy condition.
Be prepared!
Before you have to make a claim under your home insurance, it is advisable to have an up-to-date
inventory of your possessions. This could be a written listing, photographs or perhaps a video.
Your inventory should be stored AWAY FROM YOUR HOME. Should you suffer a loss by
burglary or theft, the loss must be reported to the police.
Determining Fault
No-fault insurance: What’s it all about?
It does matter who caused the accident.
You certainly can't be blamed for being confused about the term "no-fault" insurance – it’s a
commonly misunderstood term. No-fault insurance doesn't mean the insurance company lets you
off the hook if you cause an accident. Despite the misleading name, it does matter who caused the
Ontario Auto Insurance: FAQs
14
accident, and if you are found to be at fault, either completely or partially, it will go on your
insurance record. That means you may experience an increase in your future premiums.
You deal with your own insurance company.
No-fault insurance really means that if you are injured or your car is damaged in an accident, you
deal with your own insurance company, regardless of who is at fault. You don’t have to go after
the at-fault driver for vehicle damage reports or for the health care and income replacement
benefits to which you are entitled.
For example, if you were injured in a car accident, you would ask for any medical benefits
offered under your policy immediately from your company, even if you were to blame for the
accident. So you can get the help you need right away, instead of having to wait for the insurance
companies to decide who was at fault before paying any benefits.
How does an insurance company assess fault?
Someone is always determined to be “at fault” in an automobile accident, whether partially
or fully. Insurance companies must determine the degree of fault to be assigned to each
driver so they can adjust at-fault drivers’ premiums. In Quebec and Ontario, charts or rules
are used to determine fault or responsibility for property damage claims – damage to your
car – but not for injury claims. In Ontario, fault is determined by the Ontario Insurance Act
and the Fault Determination Rules of that same Act.
The Fault Determination Rules contain examples of common types of collisions and explain how
to assign fault for insurance purposes. They help insurance companies handle claims promptly
and to be fair and consistent. After you report an accident to your insurer, your company
investigates the accident and then makes a fault decision based on these rules.
The Fault Determination Rules:
 cover more than 40 accident situations, using diagrams to show specific
situations;
 can be applied to almost every possible collision scenario;
 apply regardless of road or weather conditions, visibility, point of impact on the
vehicles, or the actions of pedestrians; and
 may find you or the other driver wholly or partially at fault.
If the circumstances show more than one driver was negligent (or at fault), each driver's insurance
company may become involved in the settlement, based on the degree of responsibility connected
with each driver. If there is a dispute about responsibility, it may be necessary to go to court to
resolve it.
Visit the government website dedicated to auto insurance in the province at
www.autoinsurance.gov.on.ca to download a copy of Ontario’s Fault Determination Rules, or
visit Publications Ontario’s website at www.gov.on.ca/MBS/english/publications to find out how
to order a copy of the Fault Determination Rules by telephone, fax or mail.
How do police charges or convictions affect an insurance company’s decision?
If police don’t file charges, it doesn’t mean the insurance companies investigating the accident
will not find one or more of the drivers involved at fault.
Ontario Auto Insurance: FAQs
15
For example, if a vehicle was unable to stop on an icy road and rear-ended another, a police
officer may say neither of the drivers was “at fault.” But this relates to the laying of charges and
should not be taken as an opinion about how fault applies to an auto insurance claim. In a case
like this, the insurer would apply the rule stating that any vehicle that rear-ends another is at fault.
However, with certain types of charges, the fault determination rules don’t apply. In these cases,
fault is determined according to the ordinary rules of law.
Can fault in an automobile accident be shared?
Yes. Circumstances may show that more than one driver is partially at fault for insurance
purposes. Fault is allocated to each driver based on the accident scenario in the Fault
Determination Rules that most closely resembles the accident. If an accident is not described by
any of the scenarios, then fault is allocated according to the rules of law.
Why do I need witnesses if I’m involved in an accident?
It is important to get independent witnesses, if possible. When there are two different versions of
what caused the accident and no independent evidence, claims are usually settled on a 50/50
basis. This may affect your premium at renewal.
Will my rates go up if I am not at fault for the accident?
No. Your rates will not go up if you are 100% not at fault. However, if you are partially at fault, it
may affect your rating.
Can I recover my deductible when I am not at fault?
Your insurance company may pursue the owner of the uninsured automobile and attempt to obtain a
judgment against him or her to recover the claim and your deductible, but this could take time.
How does an at fault accident affect me?
You can be anywhere between 100% and 0% at fault. Any driver who is more than 0% at fault
will have an “at-fault” accident on his or her insurance record.
If you’re found at fault for any percentage of the accident, your premium may go up on renewal.
However, some companies allow you to maintain your driving record or premium after your first
at-fault accident. To confirm your company’s approach and how your rates will be affected, ask
your insurance representative.
In many cases, if you have your first at-fault accident after six or more years without any claims
or convictions, your premium may not change or may increase by only a small amount. Most
companies will change your driving record to reflect the accident and increase your premium by a
small amount. You will then need six years of accident-free driving before you go back to a clean
slate.
If this is your second at-fault accident in the last six years, you can expect your premiums to
increase quite significantly.
If you have any convictions or cancellations of a policy, in addition to an at-fault accident, or are
an inexperienced driver with an at-fault accident, you may be considered to be a high-risk driver
and be placed with an insurer specializing in these types of risks.
When you are shopping for insurance, always ask the insurance representative how your
premiums will be affected after an at-fault accident.
Ontario Auto Insurance: FAQs
16
In addition, remember when you lend your car to someone, you’re also lending him or her your
insurance. If the individual you lent your car to has an at-fault accident with your car, the
accident will go on your insurance record and your insurance premium could go up.
What can I do if I disagree with my insurance company’s assessment of fault?
If you don’t agree with your insurance company’s decision and believe the decision does not
accurately reflect the circumstances of the accident, speak to the claims adjuster handling your
file. Ask him or her what fault determination rule was applied in your case.
Bring any new information to your insurance company. Generally, an insurance company will
revise or reconsider its decision on fault only if additional relevant information is provided. For
example, if an accident occurred in which each driver stated the other had gone through a red
light, an insurance company would have little choice but to assign fifty-fifty fault. However, if
an eyewitness confirmed which driver went through the red light, an insurance company could
review its decision. If your insurance company refuses to revise its decision and you still
disagree, contact your company’s complaint officer. He or she will guide you through the
company’s complaint-handling procedures.
What are my rights if I drive without insurance and I'm in an accident in Ontario that's not
my fault? Can I sue the at-fault driver and recover my losses from his or her insurer?
If you drive without insurance, the Ontario Insurance Act takes away your right to recover any
loss or damage from bodily injury or death from the other person. The Act also takes away your
right to recover damage to the vehicle or its contents from the other person.
In fact, if you’re at fault, the other person's insurance company can sue you to recover the
amounts they paid out!
In conclusion, don't think "no-fault" means no blame. Your best bet is to drive safely,
whatever the insurance system in your province. No one can find fault with that
How do Accident Benefits coverages work?
Accident Benefits coverage is required by law in every province except Newfoundland and
Labrador. To encourage fairness, consumer choice and affordability, your automobile policy
offers basic coverage with options to purchase increased limits.
Basic coverage was made available so only policyholders who required higher limits (in other
words, more coverage) are forced to pay additional premiums. Policyholders who do not require
the higher limits will find insurance more affordable.
Under certain circumstances, legislation allows innocent victims of vehicle accidents to sue the
at-fault driver for pain and suffering and loss of income and future earnings, when the victim’s
Accident Benefits coverage is insufficient. A pain and suffering lawsuit is allowed only if the
injured person dies or sustains “permanent and serious” disfigurement and/or impairment of
important physical, mental or psychological function. The court is directed to assess damages and
then to deduct $30,000 ($15,000 for a Family Law Act claim).
Ontario Auto Insurance: FAQs
17
Also, an injured person may sue for 80% of net income loss before trial, 100% of gross after trial
and also for medical, rehabilitation and related costs when the injury is catastrophic. Legislation
is pending to permit claimants with permanent serious injuries to sue for excess health care costs.
Note: Ontario “insureds” involved in accidents in Quebec can choose to receive, from their own
insurance company, the Ontario benefits or the equivalent to the benefits available to Quebec
residents from the Société de l’assurance automobile du Québec.
What happens when a vehicle is a “total loss”?
A vehicle is a total loss when repairs cannot be economically or safely carried out, for example,
when repairs would cost more than the market value of the car.
Market value or actual cash value (referred to in your automobile policy) is what your vehicle
could have reasonably sold for the day before the claim. Mileage, condition of the vehicle,
equipment and retail selling price are all considered in determining the amount to be paid on the
claim.
Your insurance company calculates the vehicle's actual cash value including retail sales tax and
GST, where applicable, and offers you a cash settlement. It is your responsibility to purchase a
replacement vehicle.
From time to time, people believe they have not been offered a fair settlement. An individual can
be better informed about what is a fair settlement by doing a bit of research. Check with your
local newspapers to see the price of similar vehciles. Car dealers and automobile trade magazines
are also excellent sources for comparable pricing. Select five prices of cars similar to yours then
take the average. You should now have a reasonable ballpark figure.
Also, if you’ve completed work on your vehicle that would increase the selling price, tell your
insurance company and provide receipts to help them in determining your cash settlement.
Repairs needed to maintain your car in good running order may not increase the selling price of
your vehicle. For example, if you needed new brakes to operate your vehicle, it would not
increase the selling price because the purchaser would expect the brakes to be working properly.
However, an opinion from the person who regularly services your car on the condition and retail
value is helpful. It is preferable to get this opinion in writing.
If, after you have done your homework, you still disagree with the cash offer, go back to your
claims representative and discuss the matter. Advise him or her of the information you have
gathered and ask how the amount was determined by the company. If there is still disagreement,
discuss the matter with your insurance representative.
If you are unable to come to an agreement and the amount is $10,000 or lower, you can take the
matter to small claims court. Otherwise, if the amount is over $10,000, seek legal advice. Please
call our Consumer Information Centre at 416-362-9528 or outside Toronto at 1-800-387-2880,
Monday through Friday between 8:00 a.m. and 6:00 p.m.
We would be glad to make an inquiry on your behalf.
Ontario Auto Insurance: FAQs
18
Why isn’t my car always repaired with new parts?
Sometimes your car is repaired with new parts, but not always.
The policy or contract you signed with your insurance company calls for repairs with parts of
“similar kind and quality.”
If your vehicle is in its first production year, there will likely be only OEM (Original Equipment
Manufacturer) parts available to complete repair. These parts are new, of course.
New parts may also include "after-market" replacement parts. After-market parts can be an overrun from makers of original parts, or made by manufacturers who specialize in replacement
automobile parts. After-market parts approved by Certified Automobile Parts Association meet or
exceed Original Equipment Manufactured specifications and are suitable replacement parts.
Safety-related parts are usually always new. Regardless of the age of your vehicle, most insurance
companies will insist that safety-related parts required for repairs be new. For example, a 50%
worn tire would be replaced with a new tire and you, as policyholder, are expected to pay for the
extra tire life added to that wheel. This is called “betterment."
As any vehicle ages, it loses some of its value. That’s why the insurance company is justified in
replacing damaged parts with recycled parts which are undamaged. This complies with an
agreement in your policy.
Ontario Auto Insurance: FAQs
19
AFTER THE CLAIM
Ontario Mandatory Vehicle Branding Program:
What happens if my vehicle is severely damaged?
On March 31, 2003, the Ontario government mandated the branding of all severely
structurally damaged vehicles in Ontario.
The Vehicle Branding Program is aimed at making roads safer and countering motor vehicle
fraud and theft. The program’s major objectives are to:
 enhance road safety by ensuring proper repair of “salvage” vehicles;
 protect consumers in the vehicle marketplace;
 make the use of stolen vehicles more difficult;
 make stolen parts more difficult to re-use;
 minimize the fraudulent use of VINs from wrecked vehicles; and
 promote insurance rate stability.
These are the four different brands used:
Irreparable - a vehicle that can be used for parts or scrap only. This vehicle cannot be driven
in Ontario.
Salvage - a vehicle that can be repaired and is subject to inspection criteria approval.
Rebuilt - a vehicle that was branded as “salvage,” but has been rebuilt and inspected in
accordance with regulatory criteria.
Stolen - this brand can only be assigned or cancelled by police. It is assigned to a vehicle that
is stolen and not recovered by police. This brand makes it more difficult for thieves to register
stolen vehicles because it prevents thieves from putting the VINs from wrecks onto stolen
cars.
The following vehicles are exempt from the vehicle branding program:
Trailers, traction engines, farm tractors, road-building machines, bicycles, motor-assisted
bicycles, motorized snow vehicles, street cars and motorcycles (other than motorcycles that are
irreparable) or motor vehicles with a model year of 1980 or earlier.
What if I want to keep my damaged vehicle after a claim?
When your vehicle is a total loss, the insurance company will offer you a cash settlement, then
brand and take ownership of your vehicle. If you want to keep your vehicle and your insurer is
willing, your settlement will be reduced by the amount the insurer could get from a salvager for
the damaged vehicle.
Before you decide to keep your vehicle, consider the following:
 If a vehicle is branded as “irreparable”, it can only be used for parts. It can never be
repaired and driven.
 If a vehicle is branded “salvage” it can be fixed, but must go to an inspection station and
pass rigid safety standards to be reclassified as “rebuilt” and used on the road. The cost of
the inspection is usually over $250. The vehicle must also be towed to the inspection
station and towed away again if it does not pass inspection. The quality of any repairs
must meet the standards of the “rebuilt” classification. Also, fees for the Safety Standards
and Drive Clean Emission Certificates will apply.
Ontario Auto Insurance: FAQs
20

Considering all the costs involved, it’s not recommended that you keep a vehicle that is
branded “salvage.” There have been situations where an owner has spent a lot of money
having the vehicle repaired, only to find out later that it does not meet the “rebuilt”
standards and cannot go back on the road.
Branding reduces fraud
When you purchase a used vehicle, you may request a used car package from MTO that gives
information on the vehicle’s past owners. If the ownership was ever in the name of an insurance
company, it’s usually because the vehicle has been branded.
Brands are registered by the VIN of the vehicle. The brand is displayed on the vehicle permit
issued by MTO in Ontario or the licensing authorities in other provinces.
If a vehicle was branded as “salvage” and reclassified as “rebuilt”, you know that the vehicle has
passed a rigid inspection after being repaired and is safe to drive
This program greatly reduces fraud. Many unsuspecting consumers have purchased stolen
vehicles and later had them seized by the police with little hope of recovering the money they
paid for the vehicle. Branding offers greater consumer protection as more and more vehicles are
entered into the system and their histories are tracked. This makes it easier to tell whether or not a
car has had a questionable history.
Ontario Auto Insurance: FAQs
21
Driving in the United States
Your Ontario automobile insurance policy covers you in not only Ontario, but elsewhere in
Canada and in the USA as well.
In order to understand how this works, let’s first examine how your insurance policy applies in
Ontario.
Ontario accidents – injuries
If you’re injured in a car accident, compensation for injuries may be claimed from your own
insurance company, regardless of fault, from a pre-determined set of no-fault benefits.
In addition, should your injuries be severe enough to have met or exceeded a certain level of
seriousness known as the “threshold,” it may be possible to seek further compensation by suing
the at-fault driver or owner for pain and suffering. In most cases, such claims would involve two
different insurance companies – one for the Accident Benefits claim and another for the lawsuit.
In some cases, however, both the Accident Benefits claim and the lawsuit could be payable by the
same insurance company.
Ontario accidents – vehicle damage
To the extent you’re at fault in an accident, your claim for damage to your car would fall under
your own optional Collision or All Perils coverage.
To the extent you are not at fault, your vehicle damage would be claimed under:
 your Direct Compensation - Property Damage, provided the at-fault driver is insured by
an insurance company "licensed to transact business in Ontario" (Direct Compensation
claims will not result in an increase in premiums, provided you are not at fault at all, and
your coverage automatically provides a rental vehicle and protection for damage to nonvehicle equipment);
 your Uninsured Automobile coverage, if the driver and owner of the at-fault vehicle are
identified, but uninsured; or
 your own optional Collision or All Perils coverage if the "at-fault" vehicle cannot be
identified.
US accidents – injuries
Your Accident Benefits coverages are portable throughout Canada and the USA. The restriction
of being able to launch a lawsuit only if injuries exceed the threshold does not apply to accidents
outside Ontario. The law that applies is the law of the jurisdiction where the accident occurred.
US accidents – vehicle damage
Damage claims in the USA are handled the same way as they are in Ontario, except the Direct
Compensation system described above does not apply outside Ontario. Vehicle damage caused by
an insured at-fault driver is paid by the insurance company insuring the at-fault vehicle, not by
your own insurance company.
Determining fault
For accidents taking place in Ontario, fault is determined by a set of rules called the Fault
Determination Rules. These rules are generally not affected by traffic charges nor by subsequent
convictions nor dismissal of the charges.
Ontario Auto Insurance: FAQs
22